I-edema yamaphaphu emakati: izimpawu nezimbangela, izindlela zokuxilongwa nokwelashwa, ukuvimbela izifo

Amakati ayizilwane eziqinile futhi eziqinile. Kodwa, njengazo zonke izidalwa eziphilayo, lesi silwane sasekhaya siyagula. Izifo ezilwaneni, ngeshwa, nazo zinzima. Njengoba ngaphandle kokudla, futhi ngaphandle komoya, akekho osafunde ukuphila. Ngakho ikati lingaba nendlala ye-oxygen, futhi ngamanye amazwi - i-edema yamaphaphu. Isilwane siqala ukuphefumula futhi lapha ukuzelapha ngeke kusize: udinga ukubonana nodokotela ngokushesha. Isifo esinjalo siyingozi kunoma iyiphi into ephilayo: kumuntu, esilwaneni. Okubaluleke kakhulu ukuthi ube nesikhathi sokuhlinzeka ngosizo lwezokwelapha olufika ngesikhathi. Ukuze uqonde okungenani kancane ukuthi ingqikithi yesifo siyini, udinga ukuqonda ukuthi iyini i-edema ye-pulmonary.

Yini i-edema yamaphaphu?

I-pulmonary edema yisifo esibangelwa ukwehla kwezinga lokugeleza kwe-lymph ngaphansi kwethonya lokucindezela kwe-venous. Ngenxa yalokho, okuqukethwe kwe-pulmonary fluid kudlula okujwayelekile futhi ukushintshaniswa kwegesi kuyaphazamiseka.

Lesi sifo sibonakala ngezimpawu ezinjengokuphelelwa umoya, ukushaywa umoya kanye nokuqunjelwa.

Ngokuya ngesakhiwo sawo, amaphaphu angafaniswa nesixha samagilebhisi, lapho “igilebhisi” ngalinye lixhunywa imithambo yegazi futhi ligcwaliswe umoya.

Lawa “magilebhisi” abizwa nge-alveoli. Lapho ikati lihogela umoya ama-alveoli agcwele umoya-mpilo ngamangqamuzana egazi azungezile. Ngesikhathi sokuphefumula, i-alveoli ikhipha i-carbon dioxide.

I-edema yamaphaphu emakati yenzeka lapho i-alveoli igcwala uketshezi. Uketshezi lususa umoya kuholela ekuphazamisekeni kokunikezwa okujwayelekile kwamaphaphu umoya-mpilo. Ngenxa yalokho, kwenzeka indlala ye-oxygen.

Akukhona nje kuphela inani elidingekayo le-oxygen alanele, kodwa futhi i-carbon dioxide eqoqwe ayikwazi ukuphuma.

Izimpawu eziqondile ze-edema yamaphaphu emakati

Ukuze isilwane sethu sibe nempilo, kufanele siqaphe impilo yaso. Ngezimpawu ezincane zesifo, kufanelekile ukuthola ukuthi iyiphi inkinga okufanele ubhekane nayo futhi, uma kunesidingo, thintana nodokotela wezilwane ngokushesha.

Ukunakwa ngokukhethekile kufanele kukhokhwe uma ikati lisanda kuhlinzwa ngaphansi kwe-anesthesia. Isilwane esinempilo asikwazi ukuba nezinkinga nge-anesthesia. Kodwa uma ikati linenkinga ngenhliziyo, khona-ke kulokhu i-anesthesia inganikeza umfutho ekuthuthukiseni i-edema yamaphaphu. Kungase kungabonakali ngaso leso sikhathi, kodwa kungenzeka kube ne-edema emasontweni ambalwa alandelayo ngemva kokuhlinzwa.

Asikho isidingo sokwethuka nganoma yisiphi isizathu. Uma kusolakala ukuthi i-edema, kufanele kubonakale okungenani izimpawu ezimbili.

Izimpawu ze-edema yamaphaphu emakati zingabandakanya:

• ikati liba buthakathaka, lingasebenzi kahle, liyayeka ukuphendula kulokho okwakudala ukudlala kwalo. Lesi simo sihlobene ngokuqondile nokuntuleka komoya-mpilo. Noma yimuphi umsebenzi uholela ekuphefumuleni;
• kubonakala sengathi inkulumo engenangqondo: "ikati liphefumula njengenja." Eqinisweni, lokhu kuyisignali esabekayo, njengoba ukuphefumula ngomlomo ovulekile akuyona into evamile kumakati. Mhlawumbe ubonile ukuthi ngemva kwemidlalo eminingi ematasa, ikati lihlala livule umlomo. Lokhu kwenzeka, kodwa akuvamile futhi kuthatha umzuzu owodwa kuya kwemibili. Kwenzeka okuphambene nje lapho ikati ligula: liphefumula ngomlomo ovulekile, likhiphe ulimi lwayo, ukuphefumula nokuphefumula kubonakala;
• ukuphefumula kungenye yezimpawu zesifo samaphaphu, njengoba kucaca ngokushesha ukuthi ikati liphefumula ngandlela-thile okungalungile. Ukuphefumula okuvamile kumakati anesifuba nesisu yilokho okubizwa ngokuthi uhlobo lokuphefumula kwesifuba-sesisu. Ngesikhathi sokugula, isilwane siphefumula ngesisu;
• ukuphefumula kanzima nokungajwayelekile kuhambisana nokushaywa umoya. Ukuphefumula nakho kwenzeka ngesikhathi sezinqubo zokuvuvukala ku-pharynx noma ku-trachea, isibonelo, ngomkhuhlane. Endabeni ye-edema yamaphaphu ekati, ukuvunguza kufana ne-gurgling noma i-gurgling. Uketshezi lungabuye luphume emakhaleni;
• ukukhwehlela kungase kwenzeke ngesikhathi se-pulmonary edema. Kunjalo ukukhwehlela akuyona inkomba nalolu hlobo lwesifo, kodwa uma seluvele, lokhu kwenzeka ngokuzenzakalelayo. Ikati linenkinga yokuphefumula futhi lizama ukukhipha uketshezi olunqwabelene emaphashini. Ukukhwehlela kungase kuhambisane nenani elikhulu lesikhwehlela ngisho negazi;
• Isibonakaliso esivelele kakhulu salesi sifo i-cyanosis. I-Cyanosis ukuguga okuluhlaza okwesibhakabhaka kolwelwesi lwamafinyila. Lapha, ekati eligulayo, ngenxa yokuntuleka komoya-mpilo, ulwelwesi lwamafinyila nolimi luluhlaza okwesibhakabhaka.

Izimbangela ze-edema yamaphaphu

Zintathu izimbangela zalesi sifo emakati.

1. Endabeni yesifo senhliziyo noma i-infusions ye-intravenous esebenza ngokushesha, kukhona ukwanda kwengcindezi kuma-capillaries. Izindonga zama-capillaries ziphukile futhi ingxenye yoketshezi yegazi igelezela emaphashini.
2. Njengomphumela wezinye izifo, ingcindezi ye-oncotic iyancipha, okuncike enanini lamaprotheni kuma-capillaries kanye nekhono lawo lokugcina amanzi. Amanzi, anezinto ezincibilikisiwe kuwo, asatshalaliswa ngokulinganayo ezicutshini nasegazini. Uma ingcindezi ye-oncotic iyancipha, ke uketshezi ngeke lusabanjwa ngaphakathi komkhumbi (ama-capillaries) bese ephuma, engena ku-alveoli yamaphaphu, okubangela ukuqubuka.
3. Inyumoniya noma i-intravascular coagulation nayo ingaphula ukuvikelwa kwamaprotheni kuma-capillaries futhi uketshezi luzophuma. Lokhu kungenxa yokwanda kokungena kolwelwesi lwama-capillaries kanye ne-alveoli.

Ngaphezu kwalokhu okungenhla, singagqamisa ukuthi yini enomthelela ekuthuthukisweni kwe-edema yamaphaphu ekati:

• ikati lingakhubeka ocingweni lukagesi olungenalutho endaweni ethile futhi lishaywe wugesi;
• nakuba ama-felines athanda ukufudumala, namanje kunengozi yokushisa komzimba (esimo sezulu esishisayo emotweni evaliwe, ekamelweni elingenawo umoya ekushiseni);
• uma, ngokwesibonelo, kwaba nokuwa okuvela ekuphakameni okukhulu futhi ikati lithole ukulimala kwekhanda (ukulimala kobuchopho okubuhlungu);
• kwenzeka ukuthi abanikazi bathathe isilwane nabo baye e-dacha, lapho emidlalweni ikati lingakwazi ukukhubeka ngephutha enyoka futhi lithole ukuluma.

Ngokucabangela zonke izimbangela nezici, kuyadingeka ukuhlukanisa phakathi kwezinhlobo ze-edema: i-cardiogenic ne-non-cardiogenic.

Eyokuqala ibonakala ngokuba khona kwesifo senhliziyo.

Okwesibili kwenzeka ngenxa yokwanda kwe-capillary permeability. Akuvamile emakati kunezinja. Kuhlotshaniswa nokulimala kobuchopho okubuhlungu, ubuthi, ukushaqeka kwe-anaphylactic. Ngokuvamile kwenzeka ngenxa yokungenisa kwanoma yiziphi izinto emgudwini wokuphefumula.

Ukuxilongwa nokwelashwa kwe-edema yamaphaphu

Udokotela wezilwane wenza ukuhlola okunembile okusekelwe ekulaleleni imisindo emaphashini kanye nakwi-x-ray.

Ukulalela (i-auscultation) yesifuba sekati kwenza kube lula ukuzwa ukuvunguza emaphashini, ukububula kwenhliziyo nge-edema ye-cardiogenic.

Ukuze kwenziwe ukuxilongwa esithombeni, i-x-ray yesifuba ithathwa ngama-projections amabili ahlukene abhekene nomunye nomunye. Izicubu zamaphaphu zifiphele futhi zinomthunzi esithombeni.

Ngezinye izikhathi, uma ikati lisesimweni esibi kakhulu, ukuhlolwa kwegazi kuyenziwa. Isilwane silethwa esimweni esizinzile bese kuthathwa i-x-ray.

Ukwelashwa kwekati, lapho ukuxilongwa sekuqinisekisiwe, kuqala ngokudala indawo ezolile.

I-edema yamaphaphu emakati yisifo esibi kakhulu. Isilwane sidinga ukuphumula ayikwazi ukuphoqa okuphakelayo futhi uphuzise. Isilwane esigulayo sifuna indawo eseceleni lapho kungekho muntu ozosiphazamisa.

Ngemva kokuyisa ikati kudokotela, ukuqina kutholakala.

Okokuqala, ama-diuretics asetshenziswa ekwelapheni.

Isilwane esigulayo sivunyelwe ukuphefumula umoya-mpilo ku-oxygen mask noma sibekwe ekamelweni le-oxygen. Ezimweni ezimbi kakhulu ukuhlinzwa okungenzeka noma exhunywe kumshini wokuphefumula.

I-intravenous infusions izosiza ukubuyisela ibhalansi ye-electrolyte - ibhalansi ye-potassium ne-sodium anions emzimbeni.

Kanye nokunikeza usizo lonke ucwaningo olungase lwenziwe, njengokuthi: i-x-ray, ukuhlolwa kwegazi (okujwayelekile kanye ne-biochemical).

Ukuze ululame ngokuphelele, kuyadingeka ukugcina ikati esibhedlela, njengoba ukuqapha okuqhubekayo kuyadingeka. Lesi sikhathi ngokuvamile sisukela osukwini olulodwa kuya ezinsukwini ezintathu.

Ukuvimbela izifo

Isilwane esinesifo senhliziyo sidinga ukuqashwa njalo nguchwepheshe. Ukwelashwa okufika ngesikhathi kuzosiza isiguli esinjalo sigweme ingozi yokuthola esinye isifo.

Ikati elibonakala liphilile lingase libe sengozini ngenxa yohlobo lwalo. Ngakho-ke, kufanele uthole izici zohlobo futhi wenze ukuvimbela i-edema yamaphaphu emakati.

Izinkinga zokuphefumula eziye zavela ziwuphawu lokuxhumana ngokushesha nodokotela wezilwane.